Release of Information Consent
In order to provide timely service and communication, it is helpful for our office to give the service provider your contact information: email address and phone number (if any). The service provider will keep this contact information confidential and will not share it with anyone except their employees for the purpose of communicating and coordinating your interpreting or captioning services.
You will be asked to e-sign this agreement every term when you log in to DRC Online to enter your service requests. On occasion, you may be asked to provide a signed copy of this agreement. If requested, print this page and sign as directed below, then return the signed document to the person who requested the signed copy.
Print Name:
Signature:
Date: